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<br />110 Enclosure <br />Permittee Name: Southwest Ready Mix <br />Permit No: M-83-•175 <br />Operation Name: Alamosa Pit No 2 <br />Anniversary Date:ll/2'../86 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />_~_ Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />Remarks: ~~ ,Q`,a,~(„_ <br />Signa <br />